Harrison Caldwell had a good excuse for not being athletic: one of his legs was about a quarter inch shorter than the other, thanks to a childhood bout with polio. Plus, his feet were so flat that the Army turned him down at the height of the Vietnam War.

He had a good excuse for smoking too. He came of age in the ‘60s, when about half of American men were smokers.

But at about age 40—with a 1-year-old daughter who would soon be watching her dad’s example something clicked. 

“I had gone from around 150 [pounds] to around 160, 165,” says Caldwell, who lives in Pontotoc, MS. “Nothing bad other than the suit size changed a little bit, but you could see the writing on the wall.” 

Caldwell had a choice. He could keep up unhealthy habits and therefore accept aging as a steep downward slope. Or he could kick some changes into gear.

His decision would end up impacting him for decades, changing his mind on what was possible and helping reshape his life and the way he lived it.

The Real Fountain of Youth?

In general, by around their mid-40s to early 50s, even active people start to lose muscle and bone if they don’t do something to counteract it, says Miriam E. Nelson, PhD, director of the John Hancock Research Center on Physical Activity, Nutrition, and Obesity Prevention at Tufts University in Medford, MA. Other measures of health, like blood pressure and cardiovascular fitness, start to go downhill too. And increasing age brings a heightened risk for certain cancers and chronic diseases.

But there is something that can help you avoid or slow down all this deterioration—even reverse some of it. Some have compared this natural remedy to the fountain of youth. 

It’s plain old exercise.

Only 21 percent of American adults get the recommended amount of aerobic and strength-training exercise, according to the Centers for Disease Control and Prevention. 

“Americans are so sedentary that the ramifications of the aging process are starting earlier and earlier,” says Nelson. If you’re approaching your 40s or 50s and haven’t been active, “you better start now.”

Exercise’s Effect on Disease

Most people 65 and older have at least one chronic condition. But exercise can knock out a lot of risk factors for many of those diseases.

Heart disease? Exercise can improve your cholesterol, blood pressure, blood-vessel health and heart health.

Type 2 diabetes? Being active improves your blood sugar and insulin usage.

Alzheimer’s disease? Exercise may help you prevent it or at least slow down its progression.

Certain cancers, such as breast, lung and colon? Not only can exercise help prevent them, but it can help you survive them.

“Whether it’s heart disease, diabetes, cancer, those that are active—once they are healthy enough to become active again—have much better outcomes and survivorship,” Nelson says.

Exercise may also help prevent colds and the flu, in part by revving up the immune system. (Though intense exercise, such as running a marathon, can have the opposite effect.)

And being fit can lengthen your lifespan—by about three years on average, says David Nieman, DrPH, a professor in the Department of Health, Leisure, and Exercise Science at Appalachian State University in North Carolina. 

For example, in a 2009 study published in the British medical journal BMJ, Swedish researchers administered questionnaires to 2,205 50-year-old men, then repeated this periodically for 32 years. They found that when inactive or somewhat active men became highly active in their 50s, they were half as likely to die after more than 10 years as they would have been otherwise. This put them on par with men who had already been highly active at 50. According to this study, you may need to keep up this high fitness level for five to 10 years before your mortality risk decreases. The researchers defined “highly active” as doing heavy gardening or recreational sports for at least three hours a week, or regularly engaging in hard physical training or competitive sports.

Certainly genes also have an effect on longevity and your likelihood of getting some diseases. 

“But for the most part, exercise—even with a poor genetic makeup—does really optimize your health,” Nelson says.

Exercise’s Effect on Mobility

When Sid Heller of Boulder, CO, turned 100, he said his three keys to a good, long life were music, love and walking.

Heller has always been active. In his 20s, on his way to work, he’d get off the bus a few stops early and walk. Later, while raising a family, he worked out at the gym, bicycled, hiked and swam.

Heller kept swimming into his 90s, stopping only because getting to the pool became difficult. These days, at 104 years old, he attends seated fitness classes at his independent living community. And every morning after breakfast, he takes his walker for a stroll outside.

“I do it because I just feel like doing it,” says Heller, who hasn’t visited a doctor in over a year. “I think it’s necessary for feeling good.” According to the experts, he’s right—in more ways than one.

It’s inactivity, not just aging, that causes many of the changes in muscles and bones that people tend to see as they get older, according to the American Academy of Orthopaedic Surgeons. Exercise can reduce your risk for falls and injury and keep you as independent and active as possible.

Though muscle and bone mass seem to peak around the mid- to late 20s, “the good news is you don’t necessarily have to just lose it after age 30,” says Stephen W. Farrell, PhD, science officer in the division of education with the Cooper Institute, a fitness-focused research and education organization in Dallas. “There’s a lot we can do to hang on to what we have and even increase bone density and muscle mass beyond the age of 30.”

One key to having strong muscles and bones is resistance exercise. That can include things like lifting weights, doing floor exercises such as sit-ups and push-ups, and engaging in manual labor—like digging or splitting wood—Nieman says. 

Changing Needs—and Motivation

Though exercise gives big benefits, aging does bring some unavoidable physical changes.

“As we get older, we can’t necessarily do the same quantity or quality of exercise that we once could,” says Farrell, a former competitive runner. For example, most people gain at least a little weight as they age. ”So if you’re doing a high-impact sport like long-distance running on concrete, you might be more susceptible to things like tendonitis and stress fractures.”

Repercussions from previous injuries can also take a toll. And your body may take longer to recover from both injury and heavy exercise.

All this can do a number on your motivation—perhaps even cause you to stop exercising. But changing your focus can combat that, Farrell suggests.

“I think as we age maybe we ought to think a little bit less about exercise as a means to athletic performance and focus a little bit more on exercise and health,” he says. Also, think beyond the exercises you’re used to, Farrell advises. “Be a little bit more open-minded about all the different activities out there.”

But what if your problem isn’t changing motivation, it’s never having been motivated in the first place? Well, perhaps you just haven’t found the right activity yet. 

“I think you’ve got to bring the fun back into being active,” says Nelson, who’s the founder and director of the StrongWomen Program, which organizes community exercise programs that bring women together for their health. Try dancing or playing with your children or grandchildren, for example.

“I just think of it as part of life and not as a duty,” says Heller, of Colorado. “I just enjoyed it.” 

Caldwell enjoys being active as well. “On a bicycle, you can see everything,” he says. “I found things in Pontotoc County I hadn’t seen in 40 years.” He also likes meeting people who have similar interests when he’s out and about.

“The number one reason people report for why they keep exercising on a regular basis is that they feel better mentally,” says Nieman, who’s also director of Appalachian State University’s Human Performance Lab. In fact, in addition to its physical benefits, exercise may also help prevent depression and anxiety and may make you sleep and think better.

Is It Ever Too Late?

When Caldwell confronted his unhealthy habits at around 40 years old, he decided to make some changes.

He quit smoking and started biking. Then, thanks to a relatively new product from Nike called running shoes—this was the mid-‘80s—he discovered that he could run without pain. The shoes provided cushioning and spring for his polio-affected leg and flat feet. This newfound ability, along with a talent for swimming, led to triathlons starting at age 42. 

Now 68, he no longer does marathons but remains quite active, with a resting pulse below 50 and healthy cholesterol levels.

Over the years, Caldwell has had some bicycle accidents, but “if you’re active, you’ve built some strong bones, you can avoid a lot of fractures. I sprained an ankle but didn’t break a bone.”

Soon, he’ll have hip replacement surgery. His shorter leg made for a bad footfall, leading to hip degeneration. But his doctors tell him he’ll have no problem with the surgery, due in part to his fitness. 

“The main thing was it turned out to be fun,” Caldwell says of his exercise habit. “I enjoy it because I know it’s good for me.”

Though it’s best to be active throughout life, it’s never too late to begin, says Nelson, who was vice-chair of a committee that helped develop the 2008 Physical Activity Guidelines for Americans. “It’s what you do now that matters.”

Nieman compares starting exercise to quitting smoking: benefits start quickly and increase as time goes on. Then again, “everything is so quickly reversed when you change the habits the wrong way,” he says. “You need to make exercise like eating and sleeping. It’s just something you have to do.” 

Leigh Ann Hubbard

Leigh Ann Hubbard is a professional freelance journalist who specializes in health, aging, the American South and Alaska. Prior to her full-time freelance career, Leigh Ann worked at CNN and served as managing editor for a national health magazine. A proud aunt, Leigh Ann splits her time between Mississippi and Alaska.

At 55 years old, Heidi Christensen relishes the chance to defy stereotypes. “You didn’t just get passed by an old person,” she says of the 20- and 30-somethings she zooms by on bike paths. “You got passed by an old lady.”

Almost three decades ago, chances didn’t look good that she’d be passing anyone while bicycling—or running or swimming—ever again. This, despite the fact that she was a professional triathlete who, at age 28, had just come in fifth at the Ironman World Championships. 

The problem was, not long after that triathlon triumph, the leg weakness and pain that Christensen had been experiencing for some time intensified to the point that her legs “basically stopped working,” at least at a competitive level. Yet doctors couldn’t figure out what was wrong.

So, at the peak of her career, Christensen faced the agonizing reality many professional and recreational athletes confront around their 30s, 40s or 50s: she could no longer compete in the sport she loved. “It was a hard adjustment,” she says, “a very hard adjustment.”

Christensen quit triathlons and went on with her life, but the pull of athletics never left. Before too long, she found a related sport—and excelled in a way she’d never expected.

The Inevitable Transition

For both professional athletes and weekend warriors, athletic performance declines with age. Stamina, power or simply the time to train lessens, or injury or illness makes competing impossible.

Since athletes often shape their lives and even identities around their sports, the what’s-next period can be depressing and confusing. Some quit physical activity altogether. But others are eventually able to find athletic fulfillment in new ways. They discover a different sport, change their level of competition or feed their soul through recreational exercise.

Older athletes and experts echo similar advice for making a transition like this: stay positive and think outside the box.

Tip 1: If You Have to Quit, Experiment

In some sports, older athletes can continue participating, just at lower levels of competition. But that’s usually not the case with explosive or high-impact sports like football, basketball and hockey.

As you get older, your jumping ability and explosive power decrease, says J. D. DeFreese, PhD, program manager of the Brain and Body Health Program at the University of North Carolina’s Center for the Study of Retired Athletes.

Decreasing bone density and flexibility make injuries more likely, and recovery becomes more difficult with age. In addition, your ability to compete could be impacted by old injuries that tend to linger from high-impact activities, DeFreese says. 

Most professional athletes in sports such as these retire young, but even recreational players must usually give up the game. 

When you have to quit a sport, “you lose a part of yourself,” says Doug Gardner, EdD, coordinator of mental training services with the NFL Players Association and founder of ThinkSport Consulting Services in California. 

“It’s not just a loss, it’s a loss of a sense of purpose”—including purpose for working out since that’s been tied to the sport, Gardner explains.

To regain excitement for physical activity, Gardner recommends brainstorming other activities you’ve enjoyed or want to try and training for those. Experiment to see if you can get the same level of satisfaction from them.

After all, as people grow older, we engage in sports not as much for external rewards like getting a scholarship or making it to the pros but “because we want to grow as a person and we want to challenge ourselves,” he says. “It’s about the participation; it’s about the work; it’s about improvement.”

Tip 2: Try a New Outlet for Your Skills

Former NFL player Steve Freeman of Oxford, MS, found his workout motivation in a new job.

In 1987, after playing in the NFL for 13 years, mostly with the Buffalo Bills, Freeman retired because his body was just worn out. “I knew it was time to walk away before something major happened,” he says.

But Freeman kept right on training because he knew what he wanted to do next: be an NFL referee.

In 2001, he got his chance. In 2014, 60-year-old Freeman was called on to ref the Super Bowl, “pretty much the pinnacle of anybody’s career.”

You can play some sports from the cradle to the grave. With others, you have to compromise.

During games, “you’re running anywhere from three to five miles,” Freeman says. “I’m running up and down the field with 20-year-olds, so I have to keep my body in shape.”

Freeman, who has torn biceps and rotator cuffs and has had a number of surgeries—all, after retiring from football—maintains a rigorous training regimen and stretches every day. “If you can’t keep up with [flexibility] it’ll leave you in a hurry,” he says.

He also uses his own hyperbaric oxygen chamber, a large machine that he notes many athletes use for recovery. It pumps pure oxygen into a pressurized environment. “I pretty much stay in it five to six hours a week,” he says. The increased oxygen helps tissues heal. “It’s taken away all the soreness that I ever had. All the joint pain—everything.”

Tip 3: Make Adjustments in the Same Sport

Some sports, such as tennis, swimming and golf, offer athletes a longer lifespan than others, allowing people to transition within the sport rather than leave. They might continue at a less competitive level or simply move up in age category.

Fencing is one of those “cradle-to-grave” sports, says Donald Anthony, a former Team USA fencer who’s now board president of the United States Fencing Association. 

Older athletes have some advantages. For one thing, they listen to their bodies.

Fencing has various age classifications—the highest being 70 and older. Anthony, who’s 56, won the US national championship in his category last year.

Though he hasn’t had to leave his sport, he has noticed his abilities change. Being a married, working professional leaves less time to train, so he’s learned to maximize his strength-and-conditioning time.

But then there’s the knee arthritis. “When I was younger I used to have an extremely long, very powerful lunge,” says Anthony, who’s also the founder of the fencing-promotion company SwordSport. Arthritis precludes such a lunge today. So he made adjustments. To attack an opponent, Anthony now uses other quick footwork to close the distance and finishes with a shorter lunge. 

“That’s where I think the advantage of being an older athlete is. We listen to our bodies more,” he says, “and we have that level of experience or wisdom where we can develop ways of still being highly effective without necessarily having to focus on one area of physicality.”

Tip 4: Avoid Injury

Whether you stick with your sport or find a new one, it’s all for naught if you get sidelined by a bad injury.

Many times, people do push themselves to that point, says Jim Thornton, president of the National Athletic Trainers’ Association. “They’re still 18, 19 in their minds, and their bodies aren’t.”

To prevent injury, Thornton recommends keeping up your “muscular prowess” (perhaps through something like Pilates), warming up before competing and engaging in a daily stretching and dynamic warm-up routine. “Maintain that range of motion in all of the joints, from your ankles all the way up to the top of your noggin,” he says.

And listen to your body. Pain that lasts more than two days or that doesn’t get better means “you’re hurting yourself, and you need to see your doctor,” he says. “Exercise and movement should improve your health, not affect it negatively.”

However, DeFreese, of the Center for the Study of Retired Athletes, notes that minor pain doesn’t always mean you have to stop your sport. In fact, being sedentary could make things worse. Your doctor may recommend physical or occupational therapy instead.

When seeking out therapists and doctors, Anthony says it’s helpful if you can find someone who knows the sport. He has access to the USA Fencing team’s physical therapists and works with an orthopedic physician who’s well versed in fencing. 

Finally, before starting a new sport, Thornton recommends seeing a doctor for a preparticipation physical exam, to make sure your body—including your joints and heart—is ready to go.

Tip 5: Take Care of Yourself Mentally

If, despite these tips, you’re having trouble mentally or emotionally during this time of change, you’re not alone. “Transitions are perfectly normal parts of life,” DeFreese says, “but it’s normal for them to cause stress.”

At age 45, Gardner, a sports psychology consultant, is facing such a transition himself. He plays hockey for fun as a goalie but isn’t sure how much longer he wants to put his body through those paces. 

He believes athletes who compete recreationally sometimes feel the loss even more profoundly than professionals. For them, “it isn’t about the termination of a career. It’s about the ability to do something that brings them pleasure and enjoyment as a lifelong activity,” he says. “They’re not doing this for all of those extrinsic rewards—money, fame, glory. They’re doing this for pure love.”

Plus, “for so many people participation is about being a part of a group,” Gardner says. Once the sport is gone, that social network may be lost as well.

So surround yourself with a supportive group of friends and family if you can. And don’t be afraid of seeing a mental health professional. “I would recommend that if it’s causing them to lose sleep, if they’re depressed, they need to see somebody,” Thornton says of transitioning athletes.

Some people who have a particularly hard time may even be dealing with an addiction, says Gardner. Runners, for example, may be worried about losing that runner’s high.

But, as with any loss, there is a light at the end of this grieving tunnel, as HeidiChristensen found after she first stopped competing.

Tip 6: Find the Fun Again

In 2011, 25 years after quitting triathlons, Christensen finally got a diagnosis for what was causing that leg pain and weakness: she had blockages in arteries that supplied blood to her legs.

Turns out, this is a common condition in triathletes and bicyclists. But it was barely known when Christensen developed it. 

Surgery repaired her arteries, but by that point, Christensen had missed a quarter of a century in her sport. However, she had gained achievements in a related sport: swimming.

About seven years after quitting triathlons, having kept fit, Christensen started competing in swimming. She won national masters championships in her age group, and in 2013, at age 54, she won a 10K world masters championship in the open water.

How? Christensen learned to swim without using her legs. “A lot of women long-distance swimmers don’t use a lot of kick because it doesn’t really propel you that much for the total oxygen cost,” she says. “I mastered a really fast stroke.”

At 55, Christensen can now bike again thanks to that surgery. But she’s finding that she’s become more laid back about exercise. “I think I get more joy just from doing the activity than I used to,” she says. “I may not be as fast as I was, but I’m out there, and I’m doing it.”

“You’ve got to find a way to have fun doing whatever you’re capable of doing,” she says, “even if it’s taking the dogs for a walk for a few miles. Enjoy that as much as you can.”

Christensen is starting to have some leg pain and weakness again. But she’s trying to accept it gracefully. “Legs or no legs, I can always swim,” she says, looking on the bright side. 

That’s a thread that runs through all these athletes’ tales: stay positive. Keep your head up. Keep moving. You never know where fulfillment might come from next.

Leigh Ann Hubbard

Leigh Ann Hubbard is a professional freelance journalist who specializes in health, aging, the American South and Alaska. Prior to her full-time freelance career, Leigh Ann worked at CNN and served as managing editor for a national health magazine. A proud aunt, Leigh Ann splits her time between Mississippi and Alaska.

To be fair, at first glance, it did sound like a huge story.

“Metastatic Prostate Cancer Cases Skyrocket,” proclaimed the press-release headline in July of 2016. New cases of an incurable form of prostate cancer rose a whopping 72 percent from 2004 to 2013, according to a study from the prestigious Northwestern University.

The news headlines came fast and furious:

“Most Aggressive Form of Prostate Cancer on the Rise”

—Newsweek

“Advanced Prostate Cancer Cases Soar”

—AARP

“Advanced Prostate Cancer on the Rise, Screening at Age 50 Key to Detection”

—Huffington Post

The shocking increase could be due to “lax” screenings, the press release suggested. In recent years, various organizations, including the respected US Preventive Services Task Force (USPSTF), had relaxed their prostate-cancer screening guidelines, to some controversy. Was that the reason for the increase? Or perhaps prostate cancer, a disease that mostly affects men 50 and older, had become more aggressive.

Actually, what few reporters seemed to recognize was that there was a strong chance that neither factor was to blame—because there may have been no cancer increase at all.

This prostate-cancer frenzy was the perfect storm that experts in health and science journalism warn of. From the press release to the articles, it was a meld of sensationalism, misunderstanding and lack of due diligence.

But it wasn’t an anomaly. After all, news about research these days has become a running joke. Anything could kill you. Anything could be good for you. Think coffee is unhealthy? Just wait till tomorrow.

It’s funny, until it isn’t. Research on issues related to aging, in particular, helps shape our world. It affects medical guidelines, policy debates, social programs, even personal wellness decisions. To be accurately informed, people need to understand what the research really shows.

I’ve worked as a health journalist for over a decade, with a specialty in aging for much of that time. I started out with an unusual educational leg up: my father, James Hubbard, a family doctor and writer, taught me key points about understanding studies. Yet I still struggled at first. Research papers were gobbledygook—supposedly in English but impossible to make sense of.

Over the years, the studies haven’t gotten simpler, but I’ve gotten savvier—not only as a journalist but as a research news consumer. You can too. After all, in the midst of all that sensationalism, sometimes studies do come out that you’d actually benefit from knowing about. Deciphering which ones are likely worth a look just takes a little jargon know-how—and a deeper understanding of how research and journalism really work.

From Misled to Misleading

In the midst of the prostate-cancer frenzy, none other than Otis W. Brawley, MD, the American Cancer Society’s chief medical officer, stepped in to stem the tide.

It’s the rate that matters, not the raw numbers, he reminded the media through a statement on the ACS Pressroom Blog. “A rising number of cases can be due simply to a growing and aging population among other factors,” his statement read. If the number of new cases per 100,000 men ages 50 to 69 had risen by 72 percent, that would have been news. “In addition, in this study, the rise [the researchers] detected began before USPSTF guidelines for screening changed,” he wrote. 

Brawley continued:

The issue of whether and how screening may affect deaths from prostate cancer in the US is an incredibly important one. This study and its promotion get us no closer to the answer, and in fact cloud the waters. We hope reporters understand that and use this study to ask another important question: can we allow ourselves to be seriously misled by active promotion of flawed data on important health matters?”

His stinging question isn’t new. The problem has been discussed—by both researchers and journalists—for decades. There are remedies. But in many ways, society has only gotten further from them. 

Behind the Scenes in a Newsroom

The quality of research reporting varies. Some is fantastic. Some is abysmal. But here’s how such reporting is ideally done in my field, health journalism: a reporter reads the full study, paying particular attention to its limitations and weaknesses. She conducts interviews, including at least one with a researcher who isn’t affiliated with the study and who provides objective opinion and overall context. If part of her job is to suggest headlines for her stories, she writes one that’s not sensational or misleading.

But journalism doesn’t live in an ideal world. So here’s how health reporting is often done instead: the reporter interviews one of the lead researchers (maybe). She writes a compelling article based on that interview, the press release and the study abstract (summary). A click-worthy headline is added—either by her or an editor—and then it’s on to the next story.

What happened? No time, no education in reading studies and lots of pressure to drive clicks.

“The people who are dedicated health reporters at a lot of the major media outlets have really been dramatically cut. Where there used to be 10, 20 people, now there are two,” says Lisa Schwartz, MD, codirector of the Medicine in the Media program at the Dartmouth Institute for Health Policy and Clinical Practice.

Today’s reporters—on any beat—are notoriously overworked. In addition, “a lot of places have laid off staff like copy editors,” says Liz Seegert, a freelance health journalist who’s written for the Silver Century Foundation and is the topic leader on aging with the Association of Health Care Journalists. “So the checks and balances that used to be there have in many instances disappeared. In the rush to get published, you’ve got to be your own fact-checker, you’ve got to be your own editor.”

Yet reporters are often not even trained to do their main job. Specialty training for the health beat isn’t a big part of many university journalism programs, says Schwartz, who’s also a professor of medicine at the Dartmouth Institute. And because of the shrinking newsrooms, these reporters often don’t have so much as a mentor who’s been there longer to help them along, she points out.

Therefore, many health journalists have had no training that would, for example, help them read that prostate cancer article—whose second paragraph, by the way, begins as follows:

From the National Cancer Data Base (NCDB), all men diagnosed with adenocarcinoma of the prostate (International Classification of Diseases for Oncology histology codes 8550 and 8140) from 2004 through 2013 were included. Only patients with data available to risk stratify based on National Comprehensive Cancer Network (NCCN) guidelines were included (low risk: cT1cT2a, PSA <10 ng ml⁻¹ and Gleason score < 6; intermediate risk: cT2b–T2c, PSA 10–20 ng ml⁻¹ and Gleason score 7; high risk: cT3–4, PSA < 20 ng ml⁻¹ and Gleason score 8–10; metastatic cN1 or cM1).⁵ 

A press release is a lot easier to get through. So that’s often what journalists depend on (perhaps along with the study abstract, a brief summary of the study that’s published along with it). And some press releases do explain studies fairly. But many others exaggerate, misrepresent or worse. After all, publicists—not to mention researchers and universities—want those media hits.

“There are lots of self-interests that are served by getting great media coverage,” Schwartz says. “That’s part of how researchers advance their careers—by showing that their research is important. It’s also how institutions raise money. And part of that is to write a really exciting press release.”

Add to all this the intense pressure on the reporter to draw an audience.

“Journalists sometimes feel the need to play carnival barkers, hyping a story to draw attention to it,” health policy journalist Susan Dentzer wrote in 2009 in an article for the New England Journal of Medicine about the pitfalls of health care journalism. “This leads them to frame a story as new or different—depicting study results as counterintuitive or a break from the past—if they want it to be featured prominently or even accepted by an editor at all.”

Not all reporters fall into these traps. Paula Span, who writes the New York Times column The New Old Age, reads the studies even though she doesn’t have a science background. She calls the researchers for help translating.

“I find that most researchers are extremely glad to help out,” she says. “They want their information to get a broader audience.” If she’s reporting on a controversial issue, she’ll get opinions from researchers who weren’t involved in the study, as well.

Span also does something that many media watchers wish journalists would do more often: she reports on studies that have negative results—those that find no benefit to a treatment or supplement, for example.

Span, who’s also the author of When the Time Comes: Families with Aging Parents Share Their Struggles and Solutions (2009), believes that studies with negative findings should be covered more often. “We are coming to learn how much overtesting and overtreatment there is of older people and how detrimental this can be to them. I’ve written about a number of different studies that show no benefit to doing something.”

How to Analyze Research Stories

As the journalism, research and marketing worlds continue to sort all this out, the public still needs reliable information. So here’s how to get it: learn to be research-media savvy. The first step is to watch for three telling things in a story: association, size and risk.

First: association. One of the most common problems in research reporting is that the difference between association and causation is not made clear, says James Hubbard, MD, my father, who, full disclosure, publishes a website I edit, TheSurvivalDoctor.com.

For example, when an article says a particular fruit is “associated with” or “linked to” a reduced risk of developing some disease, that does not necessarily mean the fruit caused the reduced risk.

Usually, for association studies like this, “researchers take a big group of people and ask some questions and then try to associate different illnesses with the people’s habits,” Hubbard says. “This gives the investigators something to be suspicious of. Then more specific studies that are much more accurate and precise are done.”

For example, if a study finds that women who sip a nightly glass of red wine are less likely to get osteoporosis, maybe the wine reduced the risk. Or maybe the wine drinkers also tended to do yoga or eat dairy or do something else that was the true risk reducer. Further studies would be needed to find that out. Some studies that show association pan out; many don’t.

With association studies, there’s also often the question of which came first. For example, if older people with a positive attitude tend to be healthier, perhaps positivity improved their health. On the other hand, maybe they feel positive because they’re healthier.

Second: size. In general, bigger studies are better; smaller studies are preliminary. This is especially true of association studies, Hubbard says.

Stronger types of studies don’t have to be as large to be impactful. One of the strongest types is the randomized, double-blind, placebo-controlled study. All those terms are good to know:

• Randomized: The participants are randomly divided into groups (commonly, two). Because neither researchers nor participants choose who gets into what group, the groups are likely to be similar. For example, neither has more severely sick people.
• Double-blind: Neither the researchers nor the participants know who’s getting what treatment (for example, who’s getting what medication) until the study is over. This ensures that participants are objective about effects or the lack thereof, Hubbard explains. And researchers don’t, for instance, unknowingly give more positive reinforcement to one group than the other. (“It looks like you’re getting better.”)
• Placebo-controlled: One group gets the treatment; the other gets a placebo, a “treatment” that’s secretly inactive. When analyzing study results, researchers evaluate whether the people who got the real treatment experienced stronger effects than those who got the placebo—in other words, whether the treatment has more than just a placebo effect (an actual or perceived effect caused by believing something is affecting you even though it really isn’t).

Third: risk. When a study finds that the risk for something has increased or decreased, consider what your risk was to begin with. The book Know Your Chances (2008), available for free at the PubMed Health website, which Schwartz co-wrote, explains it this way:

When someone tells you something like this—“42 percent fewer deaths”—the most important question to ask is “42 percent fewer than what?” Unless you know what number is being lowered by 42 percent, it’s impossible to judge how big the change is.

Thinking about risk reduction is like deciding when to use a coupon at a store. Imagine that you have a coupon for 50 percent off any one purchase. You go to the store to buy a pack of gum, which costs 50 cents, and a large Thanksgiving turkey, which costs $35.00. Will you use the coupon for the gum or for the turkey? Most people would use the coupon for the turkey.

So far, you’re watching out for association, size and risk. But there are a few other important things to consider:

• Who were the subjects? Animal studies often don’t pan out in humans. For human studies, consider whether you fit into the researched category. Were the participants all one gender? Did they all have a certain disease or fall within a certain age range? For example, many studies don’t include people 65 and older even though medications commonly affect older people differently than younger ones.
• Who funded the study? Does the funder—or the researcher—have a possible conflict of interest? For instance, was a study about the amazing benefits of oranges funded by a company that sells oranges? Does the lead researcher of a medication study have a relationship with the drug’s manufacturer? If the news story doesn’t include this information, the study should. Medical journals are now providing some studies in full, for free, online. Conflicts of interest are usually listed at the end.
• Who’s quoted? Does the article include insight from someone other than the researchers involved with the study?
• Has the study been published? Where? Ideally, it’s been published in a peer-reviewed journal, meaning experts in that study’s topic evaluated it before it was accepted. Well-known examples of such journals are the New England Journal of Medicine (JAMA) and BMJ, but there are many more.

These are some of the main points experts want you to understand when you’re reading news stories about medical research. But if you want to delve deeper, check out the review criteria from HealthNewsReview.org, which publishes critiques of health-news articles. They point out, for example, that the cost and possible harms of medical interventions are important to consider, not just the exciting positive possibilities.

HealthNewsReview.org also recommends a few websites to check out for reliable medical news, including a couple of my favorites, MedPageToday, which is written for health care professionals, and Kaiser Health News.

Overall, health news tends to be hit-and-miss, according to the experts I spoke with. No one outlet was mentioned by everyone as a go-to for great medical news. Schwartz believes newspapers with health sections and with reporters dedicated to those sections tend to do a better job. Both Hubbard and Seegert say that even when you find a good source, you shouldn’t trust them implicitly. “Even the best stories and the best done studies can be skewed,” Seegert says, “so look at multiple sources.”

Positively Percolating

Despite all the problems in research-related journalism, there are some positive signs for older people concerned about health.

For one thing, even though the aging beat is “not seen as a magnet for advertising or political or market support from the editorial suites upstairs, it has stayed alive because it percolates up from the bottom of the newsroom,” says Paul Kleyman, director of the Ethnic Elders Newsbeat at New America Media. Though corporate may not be pushing for stories on issues related to aging, reporters, editors and television producers continually encounter such issues in their own lives. “I’ve always felt that, like ‘all politics are local,’ ‘all journalism is personal,’” Kleyman says.

Also, these days, a number of fellowship and training programs support journalism that’s focused on aging or health. The Silver Century Foundation cosponsors one of them through a yearly grant to the Journalists in Aging Fellows Program, run by the Gerontological Society of America and New America Media. Seegert, the topic leader on aging with the Association of Health Care Journalists, was a fellow in 2015.

One of the most important things journalists learn from educational courses is when not to cover a study, says Schwartz, whose Medicine in the Media training program is, incidentally, on hold due to a halt in federal funding for it.

“There are lots of studies that help science to move forward but that are not ready for the public,” she says. Sometimes, she’ll get an email from a journalist who’s proud to have fought to keep a study out of the news. “That prostate cancer study is a great example,” she says, noting that, though many big outlets bit, a number of others didn’t. “When journalists take a stronger line about things that they feel aren’t in the public’s interest—and argue to get those things out of the news—they’re doing an incredible public service.”

When they don’t, though, the public needn’t be fooled. There are usually red flags galore; people just need to know how to recognize them.

Leigh Ann Hubbard

Leigh Ann Hubbard is a professional freelance journalist who specializes in health, aging, the American South and Alaska. Prior to her full-time freelance career, Leigh Ann worked at CNN and served as managing editor for a national health magazine. A proud aunt, Leigh Ann splits her time between Mississippi and Alaska.

Maybelle lives with her daughter, Ella, in a two-bedroom house in rural Nevada. At 76 years old, Maybelle controls her type 2 diabetes and high blood pressure as best she can. Years of caring for her ailing husband left little time for exercise and little money for health checkups. Breaking her hip didn’t help with mobility. She uses a walker, though she doesn’t go out much.

But Maybelle loves to paint. She’ll sit for hours creating landscapes that she donates to a local charity to sell. And she sings. Maybelle and Ella sing a hymn every night before bed—a brief but welcome respite in Ella’s stressful day. And she loves. She doles out words of wisdom whenever her 24-year-old grandson will lend an ear.

In Vail, CO, Ralph, a 76-year-old former business executive, maintains a season pass to the ski slopes and travels around the world with friends, hiking and bicycling in magical landscapes Maybelle only imagines. His hometown newspaper recently profiled him as an inspirational citizen. His doctor was quoted as saying, “Ralph sets a standard we should all aspire to.”

The question: Who’s aging more successfully?

Academics have been debating theories of successful aging for decades. They’re trying to identify what it takes to have a good old age so we can all follow the prescription, ideally starting in middle age or before. But the criteria have proven difficult to pinpoint. Many attempts have all but designated groups of people as failures at aging, even though they thought they were doing pretty well, thank you very much.

At least, though, these theories promote the possibility of a fulfilling, active old age. Not long ago, that particular focus was revolutionary.

Old and Only Getting Worse

In 1984, screaming teenagers celebrated the launch of the irreverent MTV Video Music Awards, and the popular movie Footloose preached freedom for young people against the tyranny of stuffy, middle-aged fogies. To be young was to be free and cool.

And to be older? Think Murder She Wrote, which also premiered in 1984, starring Angela Lansbury as an amateur detective. Neat, huh? Yet Washington Post critic Tom Shales described Lansbury’s character as “a diminutive old auntie” and a “cute and cuddly…granny Mary Poppins.” Lansbury was 58.

If 58 was “old,” what was 78, 88…98? Just plain sad. People in later life were likely to be viewed in terms of the four D’s: dependency, disease, disability and depression, wrote Kansas State University professor Rick J. Scheidt and colleagues in a 1999 article in the Journal of Applied Gerontology. Aging meant declining, and there was little positive about it.

Before the next century rolled around, however, that view would change.

What Is Successful Aging?

In 1984, while people were celebrating youth and dreading their elder years, a large philanthropic organization, the John D. and Catherine T. MacArthur Foundation, assembled 16 scientists to study ways to help improve how people aged.

Fourteen years later, in 1998, the group’s leaders, John W. Rowe, MD, and Robert L. Kahn, PhD, published the results of their research in the book Successful Aging. It explained what separated “successful” agers from everybody else. “In sum, we were trying to pinpoint the many factors that conspire to put one octogenarian on cross-country skis and another in a wheelchair,” they wrote.

The MacArthur findings revolutionized how people looked at growing old. As the cover promised, the book showed “how the lifestyle choices you make now—more than heredity—determine your health and vitality.” Healthy living in midlife and beyond could lead to active, fulfilling later years. It seems an obvious message today. But back then, it was unusually empowering and hopeful.

Though Rowe and Kahn didn’t coin the term “successful aging,” they helped popularize it. “This model was a real game changer and paradigm shifter,” says David C. Burdick, PhD, a professor of psychology and director of the Stockton Center on Successful Aging at the Richard Stockton College of New Jersey. “Once researchers changed their focus from decline and negativity, they started to find many more positive aspects of aging.”

When Rowe and Kahn studied older people, they culled out the cream of the crop and called them “successful.”  In a nutshell, they said successful agers have:

• No disease or disease-related disability and a low risk of developing either.
• High mental and physical ability.
• An “active engagement with life,” meaning they maintain good relationships and engage in productive activities.

Sounds pretty good … but maybe a little too good. Amidst the praise and hoopla came concern. Meeting criteria that lofty wasn’t realistic for many people, some pointed out. And if you don’t successfully age, what does that make you? A failure? Or are you just a normal ager? 

The Downside of “Successful Aging”

The book Successful Aging asserts that if you try hard enough and do the right things, you have a good chance of aging healthfully and happily. But not everyone is in a position to make the best choices. For example, what if you go through a time when money’s scarce, or you have responsibilities that leave little time for personal care?

This model “implies that we are able to choose lifestyles that will lead to successful aging,” says Share DeCroix Bane, PhD, assistant research professor at the Center on Aging Studies at the University of Missouri-Kansas City. “This can lead to blaming those who do not have access to that lifestyle or who have had debilitating illness.”

One group of people this affects most is women. In their 2003 critique of Rowe and Kahn’s concept of successful aging, published in the Gerontologist, researchers Martha B. Holstein, PhD, of Chicago’s DePaul University, and Meredith Minkler, DrPH, of the University of California, Berkeley, argue that many women have been in and out of the workplace, taking time to care for children, parents or a spouse. They’re more at risk for poverty and may not have had time or funds to care for themselves. Yet they make up the majority of people who live longer lives.

The Many Faces of Successful Aging

What, then, does successful aging mean these days? And how do we accomplish it?

The Rowe and Kahn model focuses largely on health. In order to accomplish its idealistic goals, you need to:

• Stay healthy. Exercise, eat wholesome food, don’t smoke, and get appropriate health screenings and vaccines.
• Nurture personal relationships. These give you emotional and physical support and may help you maintain health-promoting activities, such as participating in walking groups.
• Maintain a good sense of self-efficacy. Rowe and Kahn define this as a belief in your ability to solve problems and meet challenges. Also, don’t let people do too much for you. Doing things for yourself rather than letting someone else take over can help maintain that self-efficacy.
• Participate in productive activities. Work in a traditional career, volunteer, help friends and family, spend time on home maintenance or improvement, or do housework, for example.

If you’re not meeting all of those criteria, you’re not alone. Studies suggest that when older people are judged solely on this model, fewer than a fifth are successfully aging, wrote British researchers Ann Bowling and Paul Dieppe in a 2005 article from the British medical journal BMJ. Yet, according to the older people themselves, half are successfully aging by their own standards, which include having good mental health and a sense of purpose.

“Today, there are actually a number of other successful-aging theories, which build upon Rowe and Kahn’s work,” says Burdick. “They don’t so much reject the theory as build in other elements—for example, as a chef would take a good recipe and add or subtract ingredients.”

According to Burdick, some of the other theories include the following characteristics:

• Good attitude. It helps to have guarded optimism about aging—believing in your ability to change and to grow.
• Purpose. A sense of meaning and purpose in life is important.
• Spirituality. “It doesn’t necessarily need to be a traditional belief in God,” Burdick says. “Some sense of being part of something bigger than one’s self—some sense of transcendence beyond one’s body and surrounding—all seem to be helpful.”

Bowling and Dieppe say researchers have explored other criteria as well. Their theories suggest that you’re aging successfully if you’re still independent, for example, or you’re learning new things or you have good coping skills. Lay people add other characteristics.  For instance, to them you’re successful if you’re satisfied with your life, or you’re financially secure or you still have a sense of humor.

What Does Successful Aging Mean to You?

With all of those theories—physical, cognitive, mental, spiritual—it’s difficult for anyone to meet the criteria. But looking on the bright side, this gives us lots of options.

We can each choose what successful aging means to us. Perhaps, like Maybelle, we’ll decide it includes expressing ourselves creatively, giving back to our community, deepening our spirituality, and being a wise and nurturing grandparent.

Or maybe we’re more like Ralph. Fitness and adventure are our calling, meeting new people, our passion.

We could even be like Brian Nelson, a 50-year-old who wrote in 2009 in the New York Times blog Well that he had survived over 40 years of bad health. At the time, side effects from cancer treatment were taking a toll. He wrote:

I get up each morning and remind myself that I’m going to be swollen, tired and nauseous. So if I get something done, like epoxy the hatches of the kayak I’m building, it’s a great day. Or if I get through all my (liquid) food, it’s a great day. Or if one of our cats comes up to say hello, rubs itself on my leg and settles down for a nap near me … yep: great day!

Nelson passed away later that year. Did he age successfully? Judging by his blog post, surely few would argue he didn’t. In fact, he was an inspiration to others—someone we could all learn from. And really, what better criterion for success is there than that?

Leigh Ann Hubbard

Leigh Ann Hubbard is a professional freelance journalist who specializes in health, aging, the American South and Alaska. Prior to her full-time freelance career, Leigh Ann worked at CNN and served as managing editor for a national health magazine. A proud aunt, Leigh Ann splits her time between Mississippi and Alaska.

Sally Jacobson had about a month to live.

A few months before, she’d been tired, sure—not feeling so great. But she was bustling along, balancing work and family in Grand Forks, ND. Then she got some great news: a promotion at work.

Within a week, her health had deteriorated so much that she couldn’t walk and breathe at the same time.

The diagnosis was autoimmune hepatitis, a disease of undetermined cause that made her body attack her liver as if it were an infection that needed to be destroyed.

She ended up in a wheelchair, with her husband as her caregiver. She couldn’t get out of bed by herself—couldn’t get off the toilet by herself. And every two to three days, she underwent thoracentesis, a process that involves having a needle stuck in your chest to remove fluid buildup.

On March 31, 2006, at 61 years of age, Jacobson was placed on the waiting list for a liver transplant. “And that’s when the surgeon asked if I would accept an older liver,” she recalls of her Mayo Clinic doctor. “He said, ‘It might give you 15 years.’ And when you know you don’t even have a month left to live, that 15 years is a pretty awesome gift.”

Many older people believe they can’t donate because their organs are worn out. Mostly, they’re wrong.

Three-and-a-half weeks later, Jacobson received her liver—from a man who died at 82.

Today, Jacobson is doing well. In fact, her doctor now believes that her liver will last past those initially predicted 15 years, she says. She spends her days volunteering at an impressive pace, spreading the word about the desperate need for more organ donors—especially the fact that, despite what too many people believe, you’re never too old to be a donor.

Why Older People Don’t Sign Up as Often to Be Donors

These days, registering to be an organ donor can be accomplished at as mundane a place as the Department of Motor Vehicles. But when today’s older generations were in their formative years, the idea of donating an organ was a profound one.

The year 1954 marked the first time an organ was successfully transplanted. It was a kidney from a living donor. In the 1960s, organ transplants from deceased donors began—and made a media splash. The surgery was featured on magazine covers and in headlines.

“Some time ago, organ failure meant certain death,” pioneering transplant surgeon George M. Abouna later reflected. “With the advent of transplantation came the hope of a second chance of life.”

During the early years, organs were generally only transplanted from younger people. It was in part because of Abouna’s work that doctors gradually learned that organs from people over 60 could work well too.

Nowadays, organs from older people are transplanted all the time, usually to people who are of a somewhat similar age. Still, members of older generations are less likely than those of younger ones to register to be organ donors.

According to a 2012 Gallup survey of more than 3,200 people, 66 percent of Americans ages 18 to 34 have granted permission on their driver’s license, and 52 percent of people 66 and older have done so.

Sixty-six percent of people on the waiting list for a transplant are 50 and older—prime candidates for an organ of about the same age.

This lesser willingness among older people matters because every donor matters. For one thing, not everyone who registers to be a donor can become one in the end—no matter their age and health.

“You need to die in a hospital to be considered an organ donor, and the majority of people do not,” says David Klassen, MD, chief medical officer of the United Network for Organ Sharing (UNOS). “Most die at home or in some other place.”

You also must die in a manner that preserves organ function—usually from an event that causes brain death, such as trauma or a severe stroke.

But older donors in particular matter because “the most rapidly growing subgroup of the waiting list is older adults,” says Dorry Segev, MD, a transplant surgeon and associate vice chair for research at Johns Hopkins University School of Medicine. “A 70-year-old waiting for a kidney doesn’t need kidneys from a 20-year-old. They could benefit significantly from kidneys from a 70-year-old.”

The problem isn’t that older people don’t believe in organ donation. Over 90 percent do, according to the Gallup survey, which was conducted for the US Department of Health and Human Services.

The first reason they say they’re not signing up is they think they’re too old—that their organs are worn out and undesirable, says Kimberly Downing, PhD, a social behavioral researcher who’s been studying donor registration among older adults for 10 years. 

But that’s just the surface answer. Probe deeper, and you find that the reasons are also health related. Because of a chronic illness, disease or medication, they’ve decided, “I’m not good for anybody,” says Downing, who’s the codirector of the Institute for Policy Research at the University of Cincinnati.

Experts say they’re often wrong—and it’s costing lives.

Why Older Organ Donors Are Desperately Needed

If today is an average day, 22 people will die waiting for an organ transplant.

This minute, over 122,000 people are on the waitlist. Almost 80,000 of them are medically eligible to receive an organ right now. Yet only 29,532 organ transplants were performed in 2014.

The necessary organs just aren’t available. The number of donors has been pretty stagnant for over a decade, yet the number of people on the waiting list has kept right on growing. (In 2005, there were just 90,526 people on it.)

And 66 percent of people on the waiting list are 50 and older, according to UNOS, the nonprofit organization that manages the United States organ transplant system. These are prime candidates for similarly aged organs.

How Health and Age Affect Organ Donation

Both your age and your health can affect what you’re able to donate—but not to the extent many people think.

Health-wise, what affects one organ doesn’t necessarily affect them all. “If you die of heart failure, you’re not likely to be eligible as a heart donor, but you might still be acceptable as a liver donor, for instance,” explains Klassen, who was a transplant nephrologist for 28 years at the University of Maryland before he joined UNOS in 2014. “Or a person who has had diabetes for many years might have suboptimal kidney function and therefore not be really a good kidney donor but might be a liver donor.”

Even if you’ve had cancer or have been told you can’t donate blood, that may not preclude you from being a donor.

Age has a similar sometimes/sometimes-not effect.

When David Coffee’s mother, Christine, died suddenly of a brain hemorrhage in May 2015, he was promptly told that she’d make a great liver donor. “I said, ‘You’re kidding me! A 90-year-old lady?’” he recalls. She was an active woman—healthy and vigorous—but still, “I was just surprised that they could use an organ from her at that age.” Her match was a 60-year-old man in New York.

Donated tendons help people move, donated veins prevent amputations and corneas help people see.

Coffee would soon learn that his mother had become the second oldest organ donor in the history of LifeGift, the organ procurement organization for north, southeast and west Texas, which was established in 1987.

The nation’s oldest donor was also a LifeGift donor: in 2006, Carlton Blackburn’s liver went to a 69-year-old a few days before Blackburn would have turned 93.

To transplant doctors, age really is just a number. “Seventy is the new ‘we’re not sure,’” says Segev.

That said, in general, organs are often matched up with people of similar ages. “One of the latest paradigm shifts in transplantation is to try to match the wear-and-tear of the organs with the wear-and-tear of the patient receiving them,” Segev says. “The phrase is, ‘to find organs that look like you.’”

“Typically, at least for kidney transplants, what we attempt to do is match organs that are expected to last the longest with patients who are expected to live the longest, or require them the longest,” says Klassen. “So we try to match the expected longest-lasting organs with, say, younger people.” But an organ that has a more limited, predicted lifespan can work well for someone who’s older. Klassen also notes that older people can sometimes be living donors—for example, donating a kidney to a family member.

How Organs Are Evaluated

Organs are medically evaluated before they’re transplanted. During her research, Downing has found that many older people don’t realize that—and therefore choose not to be donors. Women, especially, often fear they could actually harm a recipient through donation.

Depending on the organ—kidney, pancreas, liver, intestine, lung or heart—it may go through lab tests, physical tests, examinations or a biopsy, Segev says. Some organs can even undergo a bit of renovation before transplantation. “For example, kidneys, liver and lungs can go on perfusion machines,” he says. “Once you’ve taken the organ out of the patient, you can put it on a machine, and that machine can improve the function of the organ.”

But say it turns out none of the organs are usable after all. There are still many more things people can donate—namely tissues. For example, donated skin can help people with serious burns, reducing pain, scarring and infections. Donated bones can be used for spinal fusion and dental implants, or for filling in around knee or hip replacements—and even to replace bone that was lost to cancer. Donated tendons help people move, veins prevent amputations and corneas help people see.

At age 71, Robert Kauffman of Arizona died two weeks after he underwent elective surgery for a brain aneurysm. He’d been an athlete all his life, even playing NCAA basketball. “He was still playing singles tennis,” says his wife, Betsy Kauffman, who volunteers to tell her story through her state’s organ procurement organization, the Donor Network of Arizona. “He was very active physically.”

After some of his tissue was donated, Betsy Kauffman received a letter from a recipient’s family to thank her. “It turned out their daughter was trying to be in the 2016 Olympics and tore her ACL,” Kauffman says, referring to a serious knee injury. “So we were able to fix that. How cool is that?”

Other Factors That Keep People from Donating

Though concerns about age and health are the main reasons older people cite for not becoming organ and tissue donors, some other factors do come into play.

For one thing, organ transplantation is relatively new. It made the news in the ’60s, but it wasn’t until the1980s that it started becoming more common, thanks to the newly discovered immunosuppressant cyclosporine, which helped prevent people’s bodies from rejecting the organs. Because older generations didn’t grow up knowing anyone who had a transplant or who was a donor, they’re dealing with a learning curve, Downing says.

Jacobson, who had the liver transplant in 2006 at age 61, experienced some of that learning curve—mostly through relatives. “My mom had a hard time understanding it,” she says. “She’d introduce me to people, ‘This is my daughter, Sally. She had implants.’”

Another factor that affects older people more than younger ones is concern about how the donation may impact their family, Downing says. One thing they worry about is cost. They needn’t worry, though. Donation costs donor families nothing.

As far as emotional impact goes, organ donation can actually be a source of comfort. In fact, 83 percent of people believe it helps families cope with their grief, according to the Gallup survey.

Coffee, whose mother donated her liver at age 90, can testify to that. “There’s the comfort of knowing that even in that sad situation, good is coming out of it,” he says. “And then also it’s that little bit of immortality—to say, oh my gosh, she’s still living on—and it’s kind of amazing.”

It is a good idea, however, for people to talk to their family about their decision to become a donor, because if the family were to object at the hospital, their wishes would likely be respected. “Organ procurement organizations do pay very close attention to family wishes,” Klassen says. Though a family’s distressed pleas could legally be ignored, it would be unusual for the organization to go against significant family objections.

How to Register as an Organ Donor

In the United States, organ donation is completely humanitarian. Buying and selling organs is illegal, and organ procurement is highly regulated by a number of federal agencies. (It’s also overseen by UNOS and carried out according to state laws.)

So each person on that transplant waiting list is dependent on the charity of their fellow human beings. Signing up to be a donor, therefore, is a profound, potentially lifesaving thing to do. Yet it’s very easy. You can register online or when you renew your driver’s license at the Department of Motor Vehicles.

In 2012, the US Department of Health and Human Services launched the 50+ campaign—complete with a video, brochures and public service announcements—to urge people 50 and older to register as organ donors. More information about donating organs as an older adult, including downloadable materials, is available through that campaign here.

Jacobson, whose liver turned 91 this year, is grateful for the time her donor has given her. She and her husband have now been married 52 years, and since her transplant, they’ve welcomed three new grandchildren into the world.

Jacobson volunteers tirelessly with LifeSource to spread the word about organ donation. “I believe in paying it forward,” she says, “because I’ve received the most awesome gift of all—the gift of life.”

Leigh Ann Hubbard

Leigh Ann Hubbard is a professional freelance journalist who specializes in health, aging, the American South and Alaska. Prior to her full-time freelance career, Leigh Ann worked at CNN and served as managing editor for a national health magazine. A proud aunt, Leigh Ann splits her time between Mississippi and Alaska.

The pink teddy bears were what really got her. Here she was, a 59-year-old woman with breast cancer, and a stuffed animal was supposed to make her feel better.

No thank you. “That did not go down well with me. It seemed like an insult to my dignity,” says Barbara Ehrenreich, author of Bright-Sided: How Positive Thinking Is Undermining America (2009). She was diagnosed with breast cancer in 2000.

So maybe she didn’t want a teddy bear. But the intent is fair, right? Cheer up, because we all know positive thinking and a fighting spirit will help cure this thing.

Actually, no, we don’t know, Ehrenreich says. And scientists are backing her up.

Guilted into Laughter

The cancer world is steeped in messages to think positively and employ your fighting spirit. “FIGHT like a girl!” reads a bright pink T-shirt from Susan G. Komen for the Cure, a breast cancer nonprofit. “Never Give In,” implore dog tags from the Prostate Cancer Foundation.

A company called MedTees sells humorous shirts for all sorts of problems. Burn victims can declare, “I used to be a tour guide for Chernobyl.” Think dementia has no upside? Not so. Another shirt reads, “The nice thing about being SENILE…you can hide your own Easter eggs.”

Laugh or fight. They may seem different, but the ideas are similar, Ehrenreich says. The message is that changing your mind will change your outcome.

It’s possible that optimism strengthens the immune system. But explanations are elusive.

There’s nothing wrong with laughing or taking a fighting stance—if that’s your natural way of coping. The problem, scientists say, is that the message is taken too far. Positive thoughts alone are no cure. And not everyone can manifest them.

“If you just aren’t that kind of a person or you can’t summon up that upbeat attitude when you’re in the throes of retching from chemotherapy, you’re set up for feeling terribly guilty,” says Richard P. Sloan, PhD, a professor of behavioral medicine at Columbia University Medical Center and author of Blind Faith: The Unholy Alliance of Religion and Medicine (2006).

What the Science Shows

Though scientists generally believe your thoughts alone won’t cure you, some studies have found that optimism could lead to a healthier immune system, make wounds heal faster and lower your risk of heart disease and stroke, among other things. But the reasons remain somewhat elusive.

In February 2010, the scientific journal Annals of Behavioral Medicine devoted 47 pages to a debate about positive thinking and health. Arguing for the benefits, researchers Lisa G. Aspinwall, PhD, and Richard G. Tedeschi, PhD, wrote that optimistic people are more likely to take better care of themselves—exercise, eat healthfully and not smoke. They also may adhere better to medical instructions and rehabilitation. So the actions, not the thoughts, are what account for at least some of the good health outcomes.

“Positive feelings are signs of health; they do not cause good health,” says Howard S. Friedman, PhD, coauthor of The Longevity Project: Surprising Discoveries for Health and Long Life from the Landmark Eight-Decade Study (2011). “Thinking positive thoughts will not cause your cancer cells to decide to self-destruct, but it might help you get up and out of bed, eat your spinach, complete your chemotherapy, improve your digestion and get a good night’s sleep.”

It’s possible that optimism strengthens the immune system. But for cancer in particular, the evidence is “quite limited and unconvincing,” wrote researchers James C. Coyne, PhD, and Howard Tannin, PhD, in their skeptics’ argument for the Annals debate.

Plus, then you have to prove that it matters. “In some instances, tumors may even enlist the immune system to accelerate development,” they wrote. So strengthening it may not always be a benefit.

“Even if you were to accept that the connection between optimism and better health is plausible, and that’s a hypothetical, we don’t have any evidence that people changing—becoming more optimistic or more positive—reduces their risk of disease,” Sloan says. “For example, some third factor, perhaps a genetic factor, could cause both.”

When Belief Means Hope

The idea of changing your mind to change your health has been around in America since the mid-1800s, Sloan wrote in a 2011 New York Times op-ed. In 1952, Norman Vincent Peale popularized it again in his bestseller, The Power of Positive Thinking. Today, we have Rhonda Byrne’s runaway hit, The Secret (2006), with its “ask, believe, receive” philosophy.

Despite the popularity of messages that you can cure yourself through thoughts, researchers generally contend that the science doesn’t back them up. Yet many people continue to believe—and they say they have seen it work.

Patricia Wagner, a cancer patient in Arizona, is one such believer. Scientists look at this issue “strictly from the perspective of matter and scientific proof,” she says. “I am looking at it in a more holistic way.”

Wagner employs positive thinking, visualization, meditation and other complementary and alternative methods to help fight myelofibrosis, a bone-marrow disorder. She has had it since 2004 and has outlived the average life expectancy of about five years. While Wagner credits her doctors at Mayo Clinic in Scottsdale with good medical care, she gives her fighting spirit a lot of credit too.

Some people die feeling their death was their own fault because they didn’t have enough of a fighting spirit.

It led her to educate herself and to seek out what she believed was the best treatment, she says. And when her doctor told her she wouldn’t live much longer without physical therapy, visualization helped her start the process.

“I don’t think I would have had the frame [of mind] to do that had I not already been working on those positive images,” Wagner says.

The medical world can be a negative one, Wagner says. When she told a doctor about her alternative treatment methods, he responded by saying there was no evidence to support what she was doing. “You have a terminal disease,” he reminded her. “We can continue to provide palliative care, and we can hope for the best and see how long this lasts.”

“It’s not a very positive frame of mind, is it?” she says. Though she still gets appropriate medical care, she sees it as mainly precautionary.

“I have been working with my mental images so thoroughly that I really don’t believe that I could possibly have a physical problem anymore. I would just love for that moment to arrive where they say, ‘Gee, Pat, I think we must have misdiagnosed you.’ Because they’re not going to admit there was a miracle cure,” she says, laughing.

Scientists who don’t believe in the curative power of the mind don’t necessarily tell people like Wagner to stop believing. They advise them to do what’s right for them.

“People get through illness in many different ways,” Sloan says. “Some people become furious at the illness, and other people become very upbeat, but there’s no one right way.”

The Dark Side of Positive Thinking

“In the old days a man could just get sick and die. Now they have to ‘wage a battle,’” comedian Norm Macdonald quipped in his 2011 Comedy Central special Me Doing Standup. “That’s no way to end your life. ‘What a loser that guy was. The last thing he did was lose.’”

That is how the positive-thinking movement makes some people feel.

“The ugly thing is, if someone’s cancer is metastasizing, and she is being told, ‘If you just had more of a fighting spirit, you’d beat this thing,’ that’s a terrible thing to say because it’s blaming her,” Ehrenreich says. “I’ve heard also from a lot of individuals about their sisters or their mothers who died, but died feeling that it was their fault.” 

Her advice to cancer patients: “Don’t let people tell you how to feel. You know how you feel. You need people who are strong enough to hear that.”

Leigh Ann Hubbard

Leigh Ann Hubbard is a professional freelance journalist who specializes in health, aging, the American South and Alaska. Prior to her full-time freelance career, Leigh Ann worked at CNN and served as managing editor for a national health magazine. A proud aunt, Leigh Ann splits her time between Mississippi and Alaska.